Medication Self-Administration
High Alert, Hazardous Drugs, & Look-alike, Sound-alike
Provider's Orders
Medication Storage
Miscellaneous
100
What are the two patient identifiers that must be checked prior to self-administration or medication administration?
First and last name and date of birth
100
Where are the High-Alert, Hazardous, and Look- Alike/Sound-Alike medication lists displayed?
Where medication is stored and prepared for administration.
100
Under what circumstances should a Verbal Order be given?
Verbal orders will only be taken by a Nurse in an emergent situation where immediate written or electronic communication is not feasible.
100
Medication storage areas must be inspected at least how often?
Monthly!
Monthly medication storage inspections help ensure all medications and supplies are present, intact, properly stored, and not expired. This is also a great opportunity to complete medication and supply inventory, identify items that need replacement, and verify storage areas remain organized and compliant with policy.
100
After a nurse completes a non-restrictive intervention TORB/VORB, in what time frame must the provider sign/approve the TORB order?
72 hours
200
Part I: Can adult patients possess their own medications while in programming?
Part II: Should adults self-administer medications in treatment areas?
Part I: Yes
Part II: No, except in emergencies.
200
Name our two High Alert medications
Epinephrine
Insulin
200
A patient requests a second dose of ibuprofen during the same program day. What must happen prior to providing the medication?
Nursing must contact the assigned psychiatry team member for additional orders.
200
Medication refrigerator temperatures must be checked this often when medications are being stored.
DAILY!
Refrigerator temperatures should be checked and documented daily when medications are stored (Monthly when no meds are stored). Remember to reset the thermometer each time you check it. Our thermometers track the minimum and maximum temperatures reached since the last reset. If the thermometer is not reset, you won't know whether the refrigerator went out of range since your previous temperature check.
200
You mistakenly gave the wrong patient the wrong medication. Walk us through what you would do next.
1. ASSESS: Check on the patient, take vital signs, assess for adverse reaction
2. NOTIFY: Notify your DON or ADON who will walk you through the next steps (i.e. informing the psychiatry team member, informing the family)
3. DOCUMENT: Complete a Medical/Medication Safety Event Progress Note in patient's chart and complete an incident report.
300
A provider messages on Teams asking you to give a 10-year-old patient their Focalin 10mg at 12pm today. What do you need to be able to supervise the self- administration of that medication?
1. The medication in the original prescription bottle
2. Medication should be verified via Epocrates pill ID
3. Medication listed correctly on the Active Medication List
4. Medications from Home to Be Taken During Program order with the correct instructions
5. Order for nursing to supervise self-administration of medication
6. Consent from guardian for that specific medication and dose
300
Name two of our Look-alike, Sound-alike medications
acetaminophen/acetaZOLAMIDE
Benadryl/Benazepril
diphenhydrAMINE/dimenhyDRINATE
Fetzima/Farxiga
HumaLOG/HumaLIN/NovoLOG/NovoLIN
Latuda/Lantus/Lente
Motrin/Neurontin
Narcan (naloxone)/Lanoxin/Nalbuphine
Trintellix/Brintellix/Brilinta
300
A patient requests an ice pack for knee pain and has batch orders for cold compresses. What instructions should you provide before giving the ice pack?
- Do not apply directly to bare skin.
- Application of cold therapy should not exceed 20 minutes.
- Remove the cold pack if there is increased pain, numbness, tingling, excessive redness, or skin irritation.
- Notify staff if symptoms worsen or if there are concerns during use.
300
Only these staff members may physically accept a medication being dropped off at Compass.
Licensed authorized staff members (LPN, RN, NP, or MD)
Medications should never be left at the front desk or accepted by non-licensed staff. A licensed, authorized staff member must directly receive and verify the medication before it is accepted for storage.
300
When are medications reconciled?
**Hint, it's more than once**
1. Upon admission
2. After each patient encounter when medications are reviewed
400
If a medication is scheduled for supervised self-administration at 1pm, in what timeframe can you supervised self-administration of the medication and still be in compliance with our policy?
12pm-2pm. Medications are administered within one (1) hour of their scheduled dosing time, for a total window of two (2) hours.
400
What do we do differently when administering High-alert medications in non-emergency situations?
High-alert medications in non-emergency situations require a second nurse, psychiatrist, or nurse practitioner to perform a double check of the dosing and calculation and witness in the MAR. (INSULIN)
400
TORB/VORB orders for restrictive interventions must be signed by the psychiatry team member in what time frame?
24 hours
400
All controlled drugs must have a medication count sheet. The medication count sheet must be completed by two licensed, authorized staff at the following times:
When Compass receives the medications AND
At the beginning of daily PHP sessions AND
At the end of daily PHP sessions (regardless of if a dose was given that day) AND
When Compass returns medications to patient/parent OR disposes of the medications
400
We were notified of a medication recall for one of our stocked medications that we had recently provided to several patients. What steps should we take?
Immediately notify the psychiatry team members, patients, and patients (when indicated) who were administered or dispensed the medication of the reported warning, as well as any specific safety instructions from the manufacturer, FDA, or assigned provider.
Recalled medications are removed from inventory and placed in a bag/bin labeled as “DO NOT USE-RECALLED ITEM.”
500
Name a circumstance when medication administration by Compass staff would be required instead of self-administration or supervised self-administration.
- The patient is experiencing a medical emergency requiring emergency medication administration.
- The patient has been determined by the PTM to be unable to safely self-administer medications.
- The medication is a Long-Acting Injectable (LAI), which cannot be self-administered.
500
For high-alert medications, hazardous medications or look-alike/sound-alike medications, what is something the nurse must do prior to storing the medication?
High-alert medications, hazardous medications and look-alike/sound-alike medications are tagged with an appropriate worded label to indicate the warning to the administrator.
500
What should you do if you see an unfinished, vague, or illegible medication order?
Promptly notify the assigned psychiatry team member for clarification prior completing the order.
500
Each patient that brings in medication is assigned a personal medication container to store their medication. Each container has a label that contains what information?
Patient Identifiers
Allergies
Medication administration order (name, dose, route, frequency, PRN indication, and amount if not apparent on container)
Medication expiration date
Any applicable warnings provided by the pharmacy or assigned Psychiatry Team Member (PTM)
500
Name one of the Medication Assisted Treatment medications that our psychiatry team members may prescribe for our patients?
Buprenorphine
Suboxone, Subutex
Naltrexone / Vivitrol
Acamprosate
Disulfiram